NOTE: Meta-analysis studies denoted in green text.
2017
McKenzie
A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
JMIR Diabetes
This study demonstrates an individualized program delivered and supported remotely that incorporates nutritional ketosis can be highly effective in improving glycemic control and weight loss in adults with T2D while significantly decreasing medication use.
Type 2 diabetes, obesity, hypoglycemic medications
262
non-randomized parallel arm prospective
70 days
T2D
2017
Saslow
Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes
Nutrition & Diabetes
The results suggest that adults with prediabetes or noninsulin-dependent type 2 diabetes may be able to improve glycemic control with less medication by following an ad libitum very low-carbohydrate ketogenic diet compared to a moderate-carbohydrate, calorie-restricted low-fat diet. Additional research should examine both clinical outcomes and adherence beyond 12 months.
glycemic control
34
RCT
1 year
1
T2D
2017
Taus
A very low calorie ketogenic diet improves weight loss and quality of life in patients with adjustable gastric banding.
Ann Ital Chir.
KD can improve the weight loss and quality of life in patients who underwent LAGB and failed at losing more weight allowing a weight loss comparable to that obtained with a further calibration and it is useful to avoid drastic calibrations and their collateral effects.
post Gastric banding weight loss
20
non-randomized 2 arm prospective
8 weeks
s/p gastric banding for weight loss
2017
Tsaban
Dynamics of intrapericardial and extrapericardial fat tissues during long-term, dietary-induced, moderate weight loss
Am J Clin Nutr
Moderate but persistent dietary-induced weight loss substantially decreased both IPF and EPF volumes. Reduction of pericardial adipose tissues is independently associated with an improved lipid profile. The Mediterranean diet, rich in unsaturated fats and restricted carbohydrates, is superior to an LF diet in terms of the IPF burden reduction.
IPF and EPF changes during weight loss
80
RCT
18 months
1
Patient with moderate abdoinal obesity
2016
Mansoor
Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials
British Journal of Nutrition
This meta-analysis demonstrates opposite change in two important cardiovascular risk factors on LC diets – greater weight loss and increased LDL-cholesterol.
Weight loss
Meta-analysis
n/a
2016
Hall
Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men
Am J Clin Nutr
A logical consequence of the carbohydrate–insulin model is that decreasing the proportion of dietary carbohydrate to fat without altering protein or calories will reduce insulin secretion, increase fat mobilization from adipose tissue, and elevate the oxidation of circulating free fatty acids (FFAs). For those participants following the Ketogenic Diet, insulin response was superior to comparative diet.
EE, RQ and body composition
17
metabolic ward crossover
8 weeks
obese men
2016
Wycherley
Long-term effects of weight loss with a very-low carbohydrate, low saturated fat diet on flow mediated dilatation in patients with type 2 diabetes: A randomised controlled trial.
Atherosclerosis
In patients with obesity and T2DM, HighCHO diet and LowCHO diet have similar effects on endothelial function.
Bodyweight, HbA1c and FMD were assessed.
115
RCT
1 year
1
obese patients with T2D
2015
Sackner-Bernstein
Dietary Intervention for Overweight and Obese Adults: Comparison of Low-Carbohydrate and Low-Fat Diets. A Meta-Analysis
PlosOne
This trial-level meta-analysis of randomized controlled trials comparing LoCHO diets with LoFAT diets in strictly adherent populations demonstrates that each diet was associated with significant weight loss and reduction in predicted risk of ASCVD events. However, LoCHO diet was associated with modest but significantly greater improvements in weight loss and predicted ASCVD risk in studies from 8 weeks to 24 months in duration. These results suggest that future evaluations of dietary guidelines should consider low carbohydrate diets as effective and safe intervention for weight management in the overweight and obese, although long-term effects require further investigation.
Weight loss
Meta-analysis
n/a
2015
Gardner
Weight Loss on Low-Fat vs. Low-Carbohydrate Dietsby Insulin Resistance Status Among Overweight Adultsand Adults With Obesity: A Randomized Pilot Trial
Obesity
Both diets demonstrated significant weight loss, as well as improved biomarkers for many disease risk factors.
Weight loss
61
RCT
6 months
1
obese adults
2015
Throning
Diets with high-fat cheese, high-fat meat, or carbohydrate on cardiovascular risk markers in overweight postmenopausal women: a randomized crossover trial.
Am J Clin Nutr
Diets with cheese and meat as primary sources of SFAs cause higher HDL cholesterol and apo A-I and, therefore, appear to be less atherogenic than is a low-fat, high-carbohydrate diet. Also, our findings confirm that cheese increases fecal fat excretion.
blood lipids, lipoproteins, and fecal excretion of fat and bile acids
14
randomized crossover
12 weeks
overweight postmenopausal women
2014
Bazzano
Effects of Low-Carbohydrate and Low-Fat Diets
Annals of Internal Medicine
The low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrate may be an option for ersons seeking to lose weight and reduce cardiovascular risk factors.
weight, CVD risk factors
148
RCT
1 year
1
Adults without CVD or DM
2014
Jonasson
Advice to follow a low-carbohydrate diet has a favourable impact on low-grade infl ammation in type 2 diabetes compared with advice to follow a low-fat diet
Annals of Medicine
Low Carbohydrate Diet was found significantly to improve the subclinical inflammatory state in type 2 diabetes.
inflammation in T2D
61
RCT
6 months
1
Adults with T2D
2014
Maekwa
Retrospective Study on the Efficacy of a Low-Carbohydrate Diet for Impaired Glucose Tolerance
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
The LCD is effective for normalizing blood glucose and preventing progression to type-2 diabetes in patients with IGT.
normalizing blood glucose in IGT patients and preventing progression from IGT to type 2 diabetes
72
2 arm Retrospective
12 months
1
Japanese patients with impaired glucose tolerance
2014
Moreno
Comparison of a very low-calorie-ketogenic diet with a standard low-calorie diet in the treatment of obesity
Endocrine
In a group of obese patients, the VLCK diet was significantly more effective than a standard LC diet. At one year followup in the group with VLCK diet, most of the patients loss more than 10 % of their initial weight and lean mass was well preserved.
Weight loss
53
RCT
12 months
1
obesity
2014
Saslow
A Randomized Pilot Trial of a Moderate Carbohydrate Diet Compared to a Very Low Carbohydrate Diet in Overweight or Obese Individuals with Type 2 Diabetes Mellitus or Prediabetes
PlosOne
Results suggest that a very low carbohydrate diet coupled with skills to promote behavior change may improve glycemic control in type 2 diabetes while allowing decreases in diabetes medications.
glycemic control and CVD risk factors
34
RCT
3 months
overweight of obese adults with T2d or prediabetes
2014
Tay
A Very Low Carbohydrate, Low Saturated Fat Diet for Type 2 Diabetes Management: A Randomized Trial
Diabetes Care
Both diets achieved substantial improvements for several clinical glycemic control and CVD risk markers. These improvements and reductions in GV and antiglycemic medication requirements were greatest with the LC compared with HC. This suggests an LC diet with low saturated fat may be an effective dietary approach for T2DM management if effects are sustained beyond 24 weeks.
glycemic control and cardiovascular disease (CVD) risk factors in type 2 diabetes
93
RCT
6 months
1
obese patients with T2D
2014
Yamada
A Non-calorie-restricted Low-carbohydrate Diet is Effective as an Alternative Therapy for Patients with Type 2 Diabetes
Internal Medicine
Findings suggest that a low-carbohydrate diet is effective in lowering the HbA1c and triglyceride levels in patients with type 2 diabetes who are unable to adhere to a calorie-restricted diet.
glycemic control and meatabolic profiles
24
RCT
6 months
1
Japanese patients with T2D
2013
Ajala
Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes
Am J Clin Nutr
Low-carbohydrate are as effective as low-GI, Mediterranean, and highproteindiets in improving various markers of cardiovascular risk in people with diabetes and should be considered in the overall strategy of diabetes management.
Type 2 diabetes
Meta-analysis
n/a
2013
Ballard
Dietary carbohydrate restriction improves insulin sensitivity, blood pressure, microvascular function, and cellular adhesion markers in individuals taking statins
Nutrition Research
The results of this study suggest that a CRD could be a sustainable lifestyle that complements statin treatment to improve overall cardiometabolic risk, particularly for individuals with other risk factors indicative of metabolic syndrome, but future research is needed to determine the effects over a longer period of time.
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